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The prediction of violent behavior during short-term civil commitment
1University of Oklahoma Tulsa Medical College, Department of Psychiatry and Behavioral Sciences 74129.
The Bulletin of the American Academy of Psychiatry and the Law
|January 1, 1989
Summary
Clinical judgment of dangerousness for civil commitment lacks predictive validity. Aggression levels did not differ between groups, suggesting the "dangerousness" criterion should be reconsidered for mental health commitments.
Area of Science:
- Forensic Psychiatry
- Clinical Psychology
- Legal Medicine
Background:
- Civil commitment relies on clinical judgment of dangerousness.
- Accurate prediction of future dangerousness by psychiatrists is historically challenging.
- Short-term civil commitment is a critical intervention for public safety and patient care.
Purpose of the Study:
- To prospectively evaluate the predictive validity of clinical dangerousness assessments.
- To compare aggression levels in individuals civilly committed for "danger to others" versus other reasons.
- To inform policy regarding criteria for civil commitment.
Main Methods:
- Prospective study design.
- Behavioral scale ratings of verbal and physical aggression.
- Comparison between 37 "danger to others" detainees and 31 others.
Main Results:
- No statistically significant difference in aggression levels was observed between the two groups.
- Aggression levels were comparable during the approximately three-day detention period.
- Findings align with prior research on the inaccuracy of predicting dangerousness.
Conclusions:
- The "dangerousness" criterion for civil commitment demonstrates poor predictive validity.
- Rejection of the "dangerousness" criterion is proposed.
- An alternative, well-defined criterion for civil commitment is suggested to uphold parens patriae while minimizing abuse potential.